Abstract
Hand ischemic steal syndrome due to a forearm arteriovenous fistula is a rare occurrence. However, its frequency is increasing with the rise in numbers of elderly and diabetic patients. This complication, which is more common for proximal than for distal accesses, can be very severe and may cause loss of hand function, damage to fingers, and even amputation of fingers or the hand. Its treatment is difficult and often leads to access loss. We report here a case of severe hand ischemia related to a radiocephalic fistula successfully treated by ulnar artery dilatation.
Similar content being viewed by others
References
Valji D, Hye R, Roberts AC, Oglevie SB, Ziegler T, Bookstein JJ (1995) Hand ischemia in patients with hemodialysis access grafts: angiographic diagnosis and treatment. Radiology 196:697–701
Chemla E, Raynaud A, Carreres T, Sapoval M, Beyssen B, Bourquelot P, Gaux JC (1999) Preoperative assessment of the efficacy of distal radial artery ligation in treatment of steal syndrome complicating access for hemodialysis. Ann Vasc Surg 13:618–621
Van Hoek F, Scheltinga M, Luirink M, Pasmans H, Beerenhout C (2009) Banding of hemodialysis access to treat hand ischemia or cardiac overload. Semin Dial 22(2):204–208
Schanzer H, Schwartz M, Harrington E, Haimov M (1988) Treatment of ischemia due to steal by arteriovenous fistula with distal artery ligation and revascularization. J Vasc Surg 7:770–773
Haimov M, Schanzer H, Skladani M (1996) Pathogenesis and management of upper-extremity ischemia following access surgery. Blood Purif 14:350–354
Haimov M, Beaz A, Neff M, Slifkin R (1975) Complications of arteriovenous fistulas for hemodialysis. Arch Surg 110:708–712
Raynaud A, Novelli L, Bourquelot P, Stolba J, Beyssen B, Franco G (2009) Low flow maturation failure of distal accesses: treatment angioplasty of forearm arteries. J Vasc Surg 49(4):995–999
Hakaim AG, Nalbandian M, Scott T (1998) Superior maturation and patency of primary brachiocephalic and transposed basilic vein arteriovenous fistulae in patients with diabetes. J Vasc Surg 27:154–157
Guerra A, Raynaud A, Beyssen B, Pagny J-Y, Sapoval M, Angel C (2002) Arterial percutaneous angioplasty in upper limbs with vascular access devices for haemodialysis. Nephrol Dial Transplant 17:843–851
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Raynaud, A., Novelli, L., Rovani, X. et al. Radiocephalic Fistula Complicated by Distal Ischemia: Treatment by Ulnar Artery Dilatation. Cardiovasc Intervent Radiol 33, 223–225 (2010). https://doi.org/10.1007/s00270-009-9645-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-009-9645-0